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EASTON DERMATOLOGY ASSOCIATES LLC NPI 1104094655


NPI Information

NPI: 1104094655
Provider Name: EASTON DERMATOLOGY ASSOCIATES, LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 21D2026498

Address:
403 MARVEL CT
EASTON, MD
ZIP 21601
Phone: (410) 819-8867
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EASTON DERMATOLOGY ASSOCIATES, LLC is a specialist in Easton, MD. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. EASTON DERMATOLOGY ASSOCIATES, LLC NPI is 1104094655. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

403 MARVEL CT
EASTON, MD
ZIP 21601-053
Phone: (410) 819-8867
Fax: (410) 822-0416

The provider's authorized official is Michael A Del Torto .
The authorized official title is Owner and has the following contact phone number (410) 819-8867.

The CLIA number assigned to this NPI record is 21D2026498 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/19/2008 and was last updated on 10/22/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistD0059921MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H91347MEDICARE UPINMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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